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Parasitic infestations in the gastrointestinal tract

Constipation in children

Parasitic infestations - Part 2 of 2

<< Parasitic infestations - Chagas Disease <<


Alike Chagas's disease, giardiasis is also caused by a protozoal infestation, but it is more confined to infection in the upper part of the small intestine. Caused by the organism Giardia lamblia, this disease occurs most frequently in areas where hygiene and sanitation are poor, commonly affecting children in developing countries. People with increased risk for this disease include those who travel to Giardia-endemic areas, those who swallow contaminated water upon traveling or recreation, people who are immunocompromised or have poor immunity, and also including men who have sex with men.

The causative organism of giardiasis is most commonly transmitted via the fecal-oral route, since G. lamblia can be present in the feces either as a trophozoite (with flagella) or as a cyst. Humans are also the reservoir for these organisms; other animals which can serve as reservoirs are only speculated but not yet established. Gastric acid is not suitable for the survival of trophozoites; however organisms in the cyst form can survive it and consequently become infectious. These cysts, once in the gastrointestinal tract, will transform into trophozoites upon entry into the jejunum and ileum. The infectious dose is very low, requiring only as many as ten cysts! It is very important therefore to be on guard against potential reservoirs of this parasite. The common modes of transmission of cysts are food or water contamination, anal-oral sexual activity, as well as even through mere person-to-person direct contact.

The clinical manifestations of giardiasis are centrally concerning the gastrointestinal tract. Profuse and watery diarrhea is common in the acute phase of the illness, resulting to hospitalization of children due to dehydration. The disease can also progress to become chronic, and will then result to the presence of nausea, abdominal cramps, bloating, and even anorexia. The diarrhea, which can present as either daily or recurrent, can also be interrupted by bouts of constipation. The treatment for this disease is focused more on the use of pharmacologic anti-protozoal therapies, but some drugs may not be universally effective. Thus there is always a need to focus on preventive measures, such as subjecting drinking water to filtration prior to drinking.

<< Parasitic infestations - Chagas Disease <<

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